"They have said that I was slightly depressed but there are circumstances that bring that on": How Middle-Aged and Older African American Men Describe Perceived Stress and Depression.

Objective: Few studies have focused on how men perceive stress and depression, and even fewer have examined how men of a specific racial or ethnic group describe their experiences of these conditions. African American men tend to define health in ways that are inclusive of their physical health, health behaviors, and mental health, but research has largely failed to explore how men put their health and mental health in social contexts. The objective of this article is to explore how middle-aged and older African American men who self-identify as having depression: 1) differentiate stress from depression; and 2) describe depression. Design: Using data from semi-structured, individual interviews conducted between March and April 2014, we used a phenomenological approach to examine how men describe, experience, and perceive stress and depression. Setting: Nashville, Tennessee. Participants: 18 African American men aged 35-76 years who self-reported a previous or current diagnosis of depression.
Results: Men talked about the experiences of stress and how many of them viewed chronic stress as expected and depression as a normal part of life. They used phrases like being "slightly depressed" or "I take a light antidepressant" to describe how they feel and what they are doing to feel better. Within these narratives, men had difficulty distinguishing between stress and depression and they primarily explained that depression was the result of external stressors and strains. Conclusions: Men may have difficulty distinguishing between stress and depression and they may frame the causes of depression in ways that decrease their perceived culpability for its causes and limit their perceived control over the causes of depression.